Renal dysfunction in symptomatic Waldenström macroglobulinaemia: A nationwide Italian multicentre study

The prognostic significance of impaired renal function in Waldenström macroglobulinaemia (WM) remains poorly defined. We conducted a nationwide multicentre study to evaluate its clinical characteristics and prognostic impact in symptomatic patients. We analysed 402 symptomatic WM patients, stratified according to renal function at diagnosis (creatinine clearance <60 mL/min/1.73 m<sup>2</sup>). Renal dysfunction was identified in 119 patients (29.6%). Renal biopsy was performed in 33 cases. Patients with reduced renal function were older (median age 76 vs. 67 years, p < 0.0001), had lower haemoglobin levels (10.8 vs. 11.8 g/dL, p = 0.008) and higher 24-h proteinuria (0.29 vs. 0.20 g, p = 0.04). Comorbidities of renal interest were similarly distributed between groups. Renal dysfunction was associated with inferior median overall survival (139 vs. 203 months, p < 0.001) and progression-free survival (PFS) (80 vs. 106 months, p = 0.002). Among patients aged <70 years, renal dysfunction remained associated with shorter PFS (77 vs. 121 months, p = 0.005). Importantly, worsening renal function did not correlate with increasing age. In this setting, first-line chemoimmunotherapy was associated with improved median PFS. Thus, renal dysfunction at diagnosis may represent an underrecognized, independent adverse prognostic factor in symptomatic WM.

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Journal
British Journal of Haematology
Published
2026-03-08
DOI
https://doi.org/10.1111/bjh.70424
Primary Topic
Chronic Lymphocytic Leukemia Research
Type
article
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article

Renal dysfunction in symptomatic Waldenström macroglobulinaemia: A nationwide Italian multicentre study

Marcello Riva, Alessandro Noto, Emanuele Cencini, A. Barbui et al.
British Journal of Haematology
Chronic Lymphocytic Leukemia Research
article

Renal dysfunction in symptomatic Waldenström macroglobulinaemia: A nationwide Italian multicentre study

Marcello Riva, Alessandro Noto, Emanuele Cencini, A. Barbui, Benedetta Puccini, Sara Steffanoni, Francesco Piazza, I. Dogliotti, Piero Maria Stefani, Marco Merli, L. Trentin, Nicolò Danesin, Gianmarco Favrin, Alessandra Tedeschi, Simone Ferrero, Stefano Luminari, Marzia Varettoni, Angela Ferrari, Carlo Visco, Anna Maria Frustaci, Luca Laurenti, Dario Marino, Rita Rizzi, Jacopo Olivieri, Andrea Visentin, Isacco Ferrarini, Annarita Conconi, Francesco Autore
article en

Abstract

The prognostic significance of impaired renal function in Waldenström macroglobulinaemia (WM) remains poorly defined. We conducted a nationwide multicentre study to evaluate its clinical characteristics and prognostic impact in symptomatic patients. We analysed 402 symptomatic WM patients, stratified according to renal function at diagnosis (creatinine clearance <60 mL/min/1.73 m<sup>2</sup>). Renal dysfunction was identified in 119 patients (29.6%). Renal biopsy was performed in 33 cases. Patients with reduced renal function were older (median age 76 vs. 67 years, p < 0.0001), had lower haemoglobin levels (10.8 vs. 11.8 g/dL, p = 0.008) and higher 24-h proteinuria (0.29 vs. 0.20 g, p = 0.04). Comorbidities of renal interest were similarly distributed between groups. Renal dysfunction was associated with inferior median overall survival (139 vs. 203 months, p < 0.001) and progression-free survival (PFS) (80 vs. 106 months, p = 0.002). Among patients aged <70 years, renal dysfunction remained associated with shorter PFS (77 vs. 121 months, p = 0.005). Importantly, worsening renal function did not correlate with increasing age. In this setting, first-line chemoimmunotherapy was associated with improved median PFS. Thus, renal dysfunction at diagnosis may represent an underrecognized, independent adverse prognostic factor in symptomatic WM.

British Journal of Haematology
University of Siena (IT), University of Verona (IT), University of Modena and Reggio Emilia (IT), University of Padua (IT), Agostino Gemelli University Polyclinic (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Ospedale degli Infermi (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), AULSS 2 Marca Trevigiana (IT), Ospedale Papa Giovanni XXIII (IT), Istituto Oncologico Veneto (IT), Azienda Ospedaliero-Universitaria Careggi (IT), Ospedale Santa Maria della Misericordia di Udine (IT), Ca' Foncello Hospital (IT), Azienda Ospedale - Università Padova (IT), Policlinico San Matteo Fondazione (IT), Ospedale San Bortolo (IT), Ospedale degli Infermi (IT), Ospedale Valduce (IT), University of Turin (IT), University of Bari Aldo Moro (IT)
Good health and well-being
Openalex Percentile: Top 30%
Chronic Lymphocytic Leukemia Research
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